a1 Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
a2 Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana
a3 TNO Quality of Life, Leiden, The Netherlands
a4 Clinical Research Center, Charles R. Drew University, Los Angeles, CA, USA
a5 Behavioral Cardiovascular Health & Hypertension Program, Division of General Medicine, Columbia University College of Physicians & Surgeons, New York, NY, USA
Objective To investigate differences in overweight and obesity between first-generation Dutch-Ghanaian migrants in The Netherlands and their rural and urban counterparts in Ghana.
Design Cross-sectional study.
Subjects A total of 1471 Ghanaians (rural Ghanaians, n 532; urban Ghanaians, n 787; Dutch-Ghanaians, n 152) aged ≥17 years.
Main outcome measures Overweight (BMI ≥ 25 kg/m2) and obesity (BMI ≥ 30 kg/m2).
Results Dutch-Ghanaians had a significantly higher prevalence of overweight and obesity (men 69·1 %, women 79·5 %) than urban Ghanaians (men 22·0 %, women 50·0 %) and rural Ghanaians (men 10·3 %, women 19·0 %). Urban Ghanaian men and women also had a significantly higher prevalence of overweight and obesity than their rural Ghanaian counterparts. In a logistic regression analysis adjusting for age and education, the odds ratios for being overweight or obese were 3·10 (95 % CI 1·75, 5·48) for urban Ghanaian men and 19·06 (95 % CI 8·98, 40·43) for Dutch-Ghanaian men compared with rural Ghanaian men. Among women, the odds ratios for being overweight and obese were 3·84 (95 % CI 2·66, 5·53) for urban Ghanaians and 11·4 (95 % CI 5·97, 22·07) for Dutch-Ghanaians compared with their rural Ghanaian counterparts.
Conclusion Our current findings give credence to earlier reports of an increase in the prevalence of overweight/obesity with urbanization within Africa and migration to industrialized countries. These findings indicate an urgent need to further assess migration-related factors that lead to these increases in overweight and obesity among migrants with non-Western background, and their impact on overweight- and obesity-related illnesses such as diabetes among these populations.
(Received January 08 2008)
(Accepted July 07 2008)